| NPI | 1124450028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 1856324) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 1856324) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2023-10-26 |